帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Characterization of persistent HPV-specific activated T cells in head and neck squamous cell carcinoma.
Characterization of persistent HPV-specific activated T cells in head and neck squamous cell carcinoma.
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高亲和力、KLRB1 + HPV 特异性 CD8+ T 细胞代表一种持续性效应亚群,对 HPV + OPSCC 具有预后和治疗相关性。其在转移性病灶中的持续存在及与复发风险降低的关联,支持进一步研究 KLRB1 相关 HPV 反应性 T 细胞状态作为生物标志物和免疫治疗靶点。
人乳头瘤病毒阳性口咽鳞状细胞癌(HPV + OPSCC)通常预后良好,但仍易发生晚期复发。持久控制很可能依赖于持续性肿瘤特异性CD8+ T细胞,但其在转移中的持续性和功能尚不清楚。
我们将bulk RNA测序(n = 56)与肿瘤浸润CD8+ T细胞的单细胞RNA及配对T细胞受体(TCR)测序(n = 4)相结合,其中包括一对在根治性治疗后三年获取的纵向原发-肺转移配对样本。采用HPV基因分型、HLA分型、表位预测和NFAT报告基因Jurkat-luciferase试验来鉴定并功能验证HPV16 E6/E7特异性TCR。对免疫组库追踪及单细胞/bulk转录组学进行了评估。
HPV+肿瘤显示出更高的推断CD8+ T细胞浸润和比HPV-肿瘤更有利的预后。单细胞分析揭示了在HPV肿瘤特异性CD8+ T细胞中富集的寡克隆扩增耗竭簇。我们分离并功能验证了九个患者来源的HPV16 E6/E7特异性TCR。识别E6中替代剪接区域(aa 49-110;E6*)的高亲和力受体在转移病灶中持续存在,而较低亲和力的克隆,包括目前正在临床研究中的E7_11-19特异性TCR,则丢失了。与原发肿瘤相比,转移病灶显示出干性/TCF7相关CD8+ T细胞群体减少,以及表达KLRB1和ZNF683的HPV特异性CD8+ T细胞富集,这与具有抑制性信号特征的组织适应性TRM样转录状态一致。
Human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV + OPSCC) generally has favorable outcomes yet remains prone to late recurrence. Durable control likely depends on persistent tumor-specific CD8+ T cells, but their persistence and function in metastasis are poorly understood.
We integrated bulk RNA sequencing ( n = 56) with single-cell RNA and paired T-cell receptor (TCR) sequencing of tumor-infiltrating CD8+ T cells ( n = 4), including a longitudinal primary-lung metastasis pair obtained three years after curative therapy. HPV genotyping, HLA typing, epitope prediction, and NFAT-reporter Jurkat-luciferase assays were used to identify and functionally validate HPV16 E6/E7-specific TCRs. Repertoire tracking and single-cell/bulk transcriptomics were evaluated.
HPV + tumors showed higher inferred CD8+ T cell infiltration and more favorable prognosis than HPV- tumors. Single-cell analysis revealed oligoclonally expanded exhausted clusters enriched in HPV tumor-specific CD8+ T cells. We isolated and functionally validated nine patient-derived HPV16 E6/E7-specific TCRs. High-avidity receptors recognizing an alternatively spliced region in E6 (aa 49-110; E6*) persisted in metastatic lesions, whereas lower-avidity clones, including an E7_11-19-specific TCR currently under clinical investigation, were lost. Compared with the primary tumor, metastatic lesions showed reduced stem-like/TCF7-associated CD8+ T-cell populations and enrichment of HPV-specific CD8+ T cells expressing KLRB1 and ZNF683 , consistent with a tissue-adapted TRM-like transcriptional state with inhibitory signaling features.
High-avidity, KLRB1 + HPV-specific CD8+ T cells represent a persistent effector subset with prognostic and therapeutic relevance to HPV + OPSCC. Their persistence in metastatic lesions and association with reduced recurrence risk support further investigation of KLRB1 -associated HPV-reactive T-cell states as biomarkers and immunotherapeutic targets.
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